Diagnostic accuracy of ambulatory ECG monitoring in ischemic heart disease

Abstract

50 patients with precordial pain were evaluated by 24 hr ambulatory ECG monitoring during normal everyday activities, and by coronary arteriography. The monitoring was regarded as positive if deviation of the ST segment of 1 mm or more from the resting pattern was observed, or if major T wave inversion occurred. Comparison of the results of the 2 tests showed a good correlation. Among the 32 patients with positive abnormalities on ECG monitoring, 28 had severe coronary disease (>60% obstruction). Among the 18 patients with negative monitoring, only 3 had severe coronary disease. All 7 patients with major T inversion had significant coronary obstruction. The type of chest pain and the resting ECG were less indicative of coronary pathology. The good correlation demonstrated between ambulatory ECG monitoring and coronary arteriograms validates the monitoring as a reliable tool for uncovering latent ischemic heart disease (IHD) and for evaluation of patients with established IHD.